Endoskopické operace výhřezu bederních meziobratlových plotének - první zkušenosti

Title in English Endoscopic surgery for lumbar disc herniation - the first experience

MÁCA Karel ĎURIŠ Kamil SMRČKA Martin

Year of publication 2019
Type Article in Periodical
Magazine / Source Ceska a slovenska neurologie a neurochirurgie
MU Faculty or unit

Faculty of Medicine

Web http://dx.doi.org/10.14735/amcsnn2019541
Doi http://dx.doi.org/10.14735/amcsnn2019541
Keywords lumbar disc herniation; endoscopy; Visual Analogue Score; Oswestry Disabilty Index
Description Aim: Lumbar disc herniation is the most frequent indication for spinal surgery. Open discectomy is considered as a standard surgical procedure; however, the endoscopic technique has evolved recently as an alternative method of treatment. Compared to open discectomy, the endoscopic technique has a similar effect in terms of outcome and additionally, it is beneficial for both surgeon and patient, because the endoscopic technique is a minimally invasive procedure. Department of Neurosurgery in The University Hospital Brno is the first department in the Czech Republic in which endoscopic discectomy has been implemented. The aim of this article is to present the first results and experiences with this technique, which has been used in our department since 2017. Methods: So far, 15 patients (20-70 years old) underwent endoscopic surgery for L4-5 or L5-S1 herniation. Evaluation parameters were pain intensity (dorsalgia and radiculopathy) assessed by Visual Analogue Score (VAS) and limitations of common activities assessed by Oswestry Disability Index (ODI). The parameters were evaluated before surgery and after the surgery at the 6-week and 6-month time-points. Results: In all study groups the VAS score (for both dorsalgia and radiculopathy) was significantly higher before surgery compared to the 6-week and 6-month time-points. Similar results were found in male and female subgroups, and significant improvement was observed at both the 6-week and 6-month time-points. The ODI before surgery was significantly higher in all patients before surgery compared to the 6-week and 6-month time-points. In the male subgroup, there was no significant difference between ODI before surgery and the 6-week time-point, while ODI at the 6-month time-point was significantly lower. In the female subgroup, ODI at both the 6-week and 6-month timepoints was significantly lower than before surgery. Recurrent herniation had occurred in one case and was resolved by reoperation. Conclusion: In conclusion, endoscopic lumbar discectomy is a safe and effective option for lumbar disc herniation surgery.

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